Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection. It affects a woman’s reproductive organs. PID can affect one or more of the following:

The uterus (where a baby grows during pregnancy)

The ovaries (where eggs are stored)

The fallopian tubes (tubes that lead from the ovaries to the uterus — see picture below)

Some facts about PID

PID will affect about 1 out of every 7 women at some time in her life.

PID affects about 1 million American women each year.

Of these 1 million American women, between 250,000 and 350,000 are hospitalized, and more than 100 die from PID.

About 70 percent of all women with PID are under 25 years of age.

PID is the leading cause of ectopic (ek-TOP-ik) pregnancy, also known as tubal pregnancy. This is a dangerous situation, in which the pregnancy grows in the fallopian tubes instead of the uterus.

PID is the leading preventable cause of infertility (the inability to have children).

What causes PID?

PID is most often caused by a sexually transmitted disease (STD) that has not been treated or treated completely. Chlamydia (kla-MIH-dee-ah) and gonorrhea (gah-neh-REE-ah) are the STDs most often linked to PID. They are spread through unprotected sex (having sex without using a condom).

If left untreated, PID spreads upward from the cervix to the uterus, fallopian tubes, and ovaries. PID can spread throughout the pelvic area.

A woman can develop PID after having an abortion, delivering a baby, or using an IUD (intra-uterine device) for birth control. In some cases, bacteria normally present in the vagina can cause PID.

What are the symptoms of PID?

Symptoms of PID may include:

Pain and tenderness over the lower belly (abdomen)

Fever of 100.4 F (38 C) or more

Chills

Vaginal discharge that has a strong odor

Tenderness of the cervix (during sex or a pelvic exam)

Bleeding when you do not have your period

Nausea and vomiting

You may experience some or all of these symptoms. Or you may not have any symptoms.

How do you know if you have PID?

It is very difficult to diagnose PID because many of its symptoms are like those of other conditions, such as appendicitis or a bladder infection. That is why it’s very important for you to visit your doctor if you have any of the symptoms listed above.

To find out if you have PID, your doctor will do a pelvic exam. He or she will ask you questions about your symptoms and your medical history. He or she also will ask about the sexual histories of you and your partner(s). You will be tested for gonorrhea and chlamydia. You may need additional tests or procedures, like an ultrasound or laparoscopy (la-puh-ROSS-kuh-ee).

Ultrasound

During an ultrasound, a small microphone like device is moved around on the outside of the abdomen, inside the vagina, or both. The device creates sound waves that are transformed into pictures on a screen. This helps your doctor see if your organs are enlarged.

Laparoscopy

During this procedure, a small cut is made on your upper abdomen near the navel. Through this cut, a thin telescope is inserted. This lets the doctor see your internal organs. A cut also is made in the lower abdomen. A probe is inserted to remove tissue in this area. The tissue is sent out to be tested.

How is PID treated?

If found early, PID can be treated with rest and antibiotics to fight the infection. If you are given antibiotics, you must take all of the medicine — even if you feel better after just a few days. If you do not take all of the medicine, the infection is likely to return. It will be more difficult to cure the second time.

If you don’t feel somewhat better within 48 hours of beginning the antibiotics, call your doctor. If you feel pain or tenderness, ask your doctor what you can take for pain control.

If your PID is from an STD, it’s important that your partner(s) be tested and treated, so you are not re-infected.

Follow-up

You will be scheduled for a follow-up visit. It is important to keep this appointment.

Do not have sex (intercourse) until your antibiotic therapy is finished and you have seen your doctor for your follow-up appointment.

Do not use tampons or take tub baths for 2 weeks. Douching is never recommended, especially after having PID.

Complications

Other problems you may have as a result of PID are called complications. Women who have had only 1 case of PID and were treated early generally recover completely. Their ability to have children usually is not greatly affected. However, with each new episode of PID, the risk of infertility increases.

If PID is not treated early enough, the infection can cause an abscess of the ovaries and fallopian tubes. When this occurs, these areas can fill up with pus. At this point, medicine you take by mouth may not be enough. You may need to be in the hospital to have IV (intravenous) antibiotics. Your doctor may schedule surgery to prevent the abscess from bursting. An abscess that bursts can cause severe complications, like shock or even death.

Can PID be prevented?

The only sure way to prevent PID is not to have sex. Having only 1 sexual partner who is free of STDs can greatly reduce your risk. When used properly, barrier methods of birth control, such as condoms (rubbers) and spermicides, also can reduce the risk. If you develop symptoms of an STD, it is vital that you get tested and treated as soon as possible to prevent it from becoming PID.

Use condoms the right way

Except for not having sex (abstinence), latex condoms give the best protection from many sexually transmitted diseases (STDs), including HIV, the virus that causes AIDS. Condoms are helpful only if used the right way. Use a latex condom every time you have sex. Always put the condom on before the penis touches or enters the vagina. If you or your partner has an allergy to latex, you should use a polyurethane (plastic) condom.

How to use a condom

Important steps for using condoms the right way:

Open the package carefully.

Hold the condom by the last 1/2 inch at the tip and squeeze out the air.

If the penis is uncircumcised, pull back the foreskin.

Place the condom on the tip of the penis.

Unroll the condom to the base of the penis. Smooth out any extra air.

If you want or need to use lubricant on the condom, only use water-based lubricants like KY Jelly or Surgilube. Do not use oil-based lubricants. They can weaken condoms and cause them to break. Do not use petroleum jelly, cooking or vegetable oil, mineral or baby oil, massage oil, butter or margarine, or oil-based creams or lotions.

Immediately after ejaculation, hold the condom firmly by the rim at the base ofthe penis, and pull the penis and condom out of the vagina together while the penisis still erect.

Look carefully at the condom to see if there is a hole in the condom. If you are not sure, fill the condom with water to see if it leaks.

Discard the condom. Wrap it in tissue and throw it away. Do not flush it down the toilet.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

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